Marie Skougaard1,2,3, Henning Bliddal1,2,3, Robin Christensen1,2,3, Karen Ellegaard1,2,3, Sabrina M Nielsen1,2,3, Jakub Zavada1,2,3, Sabina Oreska1,2,3, Niels S Krogh1,2,3, Christian C Holm1,2,3, Merete L Hetland1,2,3, Jiri Vencovsky1,2,3, Henrik Røgind1,2,3, Peter C Taylor1,2,3, Henrik Gudbergsen4,5,6. 1. From The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense; Zitelab ApS, Copenhagen, Denmark; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Institute of Rheumatology, Prague; Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic; Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. 2. N.S. Krogh is CEO of Zitelab ApS and developer of the ELECTOR online platform. 3. M. Skougaard, MD, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; H. Bliddal, MD, DMSc, Professor, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; R. Christensen, BSc, MSc, PhD, Professor, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, and Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital; K. Ellegaard, PT, PhD, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; S.M. Nielsen, BSc, MSc, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, and Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital; J. Zavada, MD, PhD, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University; S. Oreska, MD, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University; N.S. Krogh, CEO, Zitelab ApS; C.C. Holm, MSc, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; M.L. Hetland, MD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; J. Vencovsky, Professor, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University; H. Røgind, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet; P.C. Taylor, Professor, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; H. Gudbergsen, MD, PhD, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg. 4. From The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense; Zitelab ApS, Copenhagen, Denmark; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Institute of Rheumatology, Prague; Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic; Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. rindelgudbergsen@gmail.com. 5. N.S. Krogh is CEO of Zitelab ApS and developer of the ELECTOR online platform. rindelgudbergsen@gmail.com. 6. M. Skougaard, MD, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; H. Bliddal, MD, DMSc, Professor, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; R. Christensen, BSc, MSc, PhD, Professor, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, and Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital; K. Ellegaard, PT, PhD, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; S.M. Nielsen, BSc, MSc, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, and Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital; J. Zavada, MD, PhD, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University; S. Oreska, MD, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University; N.S. Krogh, CEO, Zitelab ApS; C.C. Holm, MSc, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg; M.L. Hetland, MD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; J. Vencovsky, Professor, Institute of Rheumatology, and Department of Rheumatology, First Faculty of Medicine, Charles University; H. Røgind, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet; P.C. Taylor, Professor, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; H. Gudbergsen, MD, PhD, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg. rindelgudbergsen@gmail.com.
Abstract
OBJECTIVE: In an eHealth setting, to investigate intra- and interrater reliability and agreement of joint assessments and Disease Activity Score using C-reactive protein (DAS28-CRP) in patients with rheumatoid arthritis (RA) and test the effect of repeated joint assessment training. METHODS: Patients with DAS28-CRP ≤ 5.1 were included in a prospective cohort study (clinicaltrials.gov: NCT02317939). Intrarater reliability and agreement of patient-performed joint counts were assessed through completion of 5 joint assessments over a 2-month period. All patients received training on joint assessment at baseline; only half of the patients received repeated training. A subset of patients was included in an appraisal of interrater reliability and agreement comparing joint assessments completed by patients, healthcare professionals (HCP), and ultrasonography. Cohen's κ coefficients and intraclass correlation coefficients (ICC) were used for quantifying of reliability of joint assessments and DAS28-CRP. Agreement was assessed using Bland-Altman plots. RESULTS: Intrarater reliability was excellent with ICC of 0.87 (95% CI 0.83-0.90) and minimal detectable change of 1.13. ICC for interrater reliability ranged between 0.69 and 0.90 (good to excellent). Patients tended to rate DAS28-CRP slightly higher than HCP. In patients receiving repeated training, a mean difference in DAS28-CRP of -0.08 was observed (limits of agreements of -1.06 and 0.90). After 2 months, reliability between patients and HCP was similar between groups receiving single or repeated training. CONCLUSION: Patient-performed assessments of joints and DAS28-CRP in an eHealth home-monitoring solution were reliable and comparable with HCP. Patients can acquire the necessary skills to conduct a correct joint assessment after initial and thorough training. [clinicaltrials.gov (NCT02317939)].
OBJECTIVE: In an eHealth setting, to investigate intra- and interrater reliability and agreement of joint assessments and Disease Activity Score using C-reactive protein (DAS28-CRP) in patients with rheumatoid arthritis (RA) and test the effect of repeated joint assessment training. METHODS:Patients with DAS28-CRP ≤ 5.1 were included in a prospective cohort study (clinicaltrials.gov: NCT02317939). Intrarater reliability and agreement of patient-performed joint counts were assessed through completion of 5 joint assessments over a 2-month period. All patients received training on joint assessment at baseline; only half of the patients received repeated training. A subset of patients was included in an appraisal of interrater reliability and agreement comparing joint assessments completed by patients, healthcare professionals (HCP), and ultrasonography. Cohen's κ coefficients and intraclass correlation coefficients (ICC) were used for quantifying of reliability of joint assessments and DAS28-CRP. Agreement was assessed using Bland-Altman plots. RESULTS: Intrarater reliability was excellent with ICC of 0.87 (95% CI 0.83-0.90) and minimal detectable change of 1.13. ICC for interrater reliability ranged between 0.69 and 0.90 (good to excellent). Patients tended to rate DAS28-CRP slightly higher than HCP. In patients receiving repeated training, a mean difference in DAS28-CRP of -0.08 was observed (limits of agreements of -1.06 and 0.90). After 2 months, reliability between patients and HCP was similar between groups receiving single or repeated training. CONCLUSION:Patient-performed assessments of joints and DAS28-CRP in an eHealth home-monitoring solution were reliable and comparable with HCP. Patients can acquire the necessary skills to conduct a correct joint assessment after initial and thorough training. [clinicaltrials.gov (NCT02317939)].
Entities:
Keywords:
DISEASE ACTIVITY SCORE; HOME MONITORING; RELIABILITY; RHEUMATOID ARTHRITIS; SELF-MANAGEMENT
Authors: Bryant R England; Claire E H Barber; Martin Bergman; Veena K Ranganath; Lisa G Suter; Kaleb Michaud Journal: Arthritis Care Res (Hoboken) Date: 2021-12 Impact factor: 5.178
Authors: S W Tas; G J Wolbink; L Boekel; F Hooijberg; E H Vogelzang; P L Klarenbeek; W H Bos Journal: Arthritis Res Ther Date: 2021-08-05 Impact factor: 5.156